Abstract
We have studied 3 newborns affected by severe hypoxic encefalopathy in order to determine the brain death by Magnetic Resonance imaging (MRI) (SE T1 weighted axial and sagittal, FSE T2 weighted axial and coronal, FLAIR axial), 1H-Magnetic Spectroscopy (1H-MRS) (single voxel 8 cm3 located in the basal ganglia and in the white matter with PRESS — point resolved spectroscopy- TE 40, 135, 270), diffusion imaging (Dwi) (b value 800–1200) and MR angiography (ToF 2D arterial and ToF 2D venous). In the cases studied in order to permitt a possible organ-transplantation, we have observed the following data: very severe brain oedema with white matter signal hypointensity in T1wi and signal hyperintensity in T2wi, loss of subarachnoid spaces, signal alterations of brainstem and basal ganglia, absent intracranial arterial and venous vascular flow, reduction of NAA/Cr and increase of Lac/Cr in the spectroscopy evaluation, a massive drop in ADC values with different regional distribution. The MRI, MR-angiography, Dwi and 1H-MRS can help in the determination of brain death.